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. 2017 Nov;58(6):1119-1127.
doi: 10.3349/ymj.2017.58.6.1119.

Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Seung Hyun Lee  1   2 , Hancheol Lee  3 , Jin Kyu Park  1 , Jae Sun Uhm  1 , Jong Youn Kim  1 , Hui Nam Pak  1 , Moon Hyoung Lee  1 , Ho Geun Yoon  2 , Boyoung Joung  4
Affiliations

Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Seung Hyun Lee et al. Yonsei Med J. 2017 Nov.

Abstract

Purpose: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG) surgery. This study evaluated gender differences in the long-term clinical implications of POAF.

Materials and methods: After propensity score matching, a gender-based comparison of long-term (>1 year) newly developed atrial fibrillation (LTAF) and mortality between 1664 (480 females) consecutive patients with (POAF) and without POAF (no-POAF) who had undergone CABG was performed.

Results: During a follow-up of 49±28 months, cumulative survival free of LTAF was lower in the POAF group than in the no-POAF group for both males (92.1% vs. 98.2%, p<0.001) and females (84.1% vs. 98.0%, p<0.001). However, female patients with POAF more frequently developed LTAF than male POAF patients (13.9 % vs. 6.9%, p=0.049). In multivariate analysis, POAF was a significant predictor of LTAF among males [hazard ratio (HR) 4.91; 95% confidence interval (CI) 1.22-19.79, p=0.031] and females (HR 16.50; 95% CI 4.79-56.78; p<0.001). POAF was a predictor of long-term mortality among females (adjusted HR 3.96; 95% CI 1.13-13.87, p=0.033), but not among males.

Conclusion: Although POAF was related to LTAF in both genders, cumulative survival free of LTAF was poorer among females than among males. Additionally, a significant correlation with long-term mortality after CABG was observed among female patients with POAF.

Keywords: Atrial fibrillation; coronary artery bypass graft; gender; postoperative complications; survival.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Flow diagram and follow-up for new-onset POAF, LTAF, and mortality. CABG, coronary artery bypass graft; AF, atrial fibrillation; POAF, postoperative atrial fibrillation; LTAF, long-term (>1 year) newly developed atrial fibrillation.
Fig. 2
Fig. 2. Kaplan-Meier curves for survival free of LTAF according to the presence of POAF in the overall (A) and propensity score-matched patients (B). The left and right panels show the survival curves in the male and female patients according to POAF, respectively. The POAF group had a lower cumulative survival free of LTAF than the no-POAF group among both the overall and propensity score-matched patients (all p<0.001). The female POAF group had a lower cumulative survival free of LTAF than the male POAF group among the propensity score-matched patients (p=0.049). LTAF, long-term (>1 year) newly developed atrial fibrillation; POAF, postoperative atrial fibrillation; AF, atrial fibrillation.
Fig. 3
Fig. 3. Kaplan-Meier curves for survival free of long-term mortality according to the presence of POAF in the overall (A) and propensity score-matched patients (B). The left and right panels show the survival curves in the male and female patients according to POAF, respectively. The POAF group had a lower cumulative survival free of long-term mortality than the no-POAF group among both the overall and propensity score-matched patients (all p<0.050). POAF, postoperative atrial fibrillation.
See this image and copyright information in PMC

References

    1. Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med. 2001;135:1061–1073. - PubMed
    1. Ommen SR, Odell JA, Stanton MS. Atrial arrhythmias after cardiothoracic surgery. N Engl J Med. 1997;336:1429–1434. - PubMed
    1. Shantsila E, Watson T, Lip GY. Atrial fibrillation post-cardiac surgery: changing perspectives. Curr Med Res Opin. 2006;22:1437–1441. - PubMed
    1. Lahtinen J, Biancari F, Salmela E, Mosorin M, Satta J, Rainio P, et al. Postoperative atrial fibrillation is a major cause of stroke after on-pump coronary artery bypass surgery. Ann Thorac Surg. 2004;77:1241–1244. - PubMed
    1. Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT, et al. Multi-Center Study of Perioperative Ischemia Research Group. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. JAMA. 1996;276:300–306. - PubMed

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